Factors affecting quality of life in keratoconus.

PURPOSE: To identify the factors affecting the quality of life (QoL) in adults with keratoconus, using the disease-specific Keratoconus Outcomes Research Questionnaire (KORQ). METHODS: In this cross-sectional study, 574 patients with keratoconus completed the 29-item KORQ (18-item activity limitations and 11-item symptoms subscales) and demographic information. Based on mean corneal curvature to grade keratoconus severity, participants were categorised into four groups: mild <48 dioptres [D]; moderate: 48 to 53 D; advanced: 54 to 55 D and severe: >55D. Rasch analysis was used to assess the psychometric properties and to score the KORQ. Multivariable regression was performed to determine the independent impact of age, sex, laterality, severity and duration of keratoconus, education, employment status and mode of treatment for keratoconus on activity limitations and symptoms. RESULTS: Mean (SD) age was 24.5 (5.1) years. 304 (53%), 160 (28%), 26 (4%) and 84 (15%) belonged to keratoconus groups 1, 2, 3 and 4, respectively. Rasch analysis demonstrated the 'activity limitations' and 'symptoms' KORQ subscales to possess good psychometric properties. Statistically significant associations were found between activity limitation score and the following measures: visual acuity (VA) in the better-seeing eye (r = -0.10, p = 0.01); VA in the worse-seeing eye (r = -0.09, p = 0.04) and ocular aberrations (r = -0.13, p = 0.008) in the worse-seeing eye. Statistically significant associations were also found between symptoms score and mean corneal curvature in the better-seeing eye (r = -0.10, p = 0.02). In regression models, female sex was associated with 21% worse symptom score than male (ß = -0.33, 95% CI, -0.09, -0.59, p = 0.01) and working people experienced clinically and statistically significantly greater trouble from symptoms compared to those not working (ß =0.44, 95% CI, 0.17, 0.70, p = 0.001). CONCLUSIONS: People with keratoconus have poorer QoL in terms of activity limitations if they have poorer VA and greater wavefront aberrations, and in terms of symptoms if they are female and employed.

Self-Assembled Fluorosome-Polydopamine Complex for Efficient Tumor Targeting and Commingled Photodynamic/Photothermal Therapy of Triple-Negative Breast Cancer.

Photodynamic/photothermal therapy (PDT/PTT) that deploys a near-infrared responsive nanosystem is emerging to be a promising modality in cancer treatment. It is highly desirable to have a multifunctional nanosystem that can be used for efficient tumor targeting and inhibiting metastasis/recurrence of cancer. In the current study, self-assembled chlorophyll-rich fluorosomes derived from Spinacia oleracea were developed. These fluorosomes were co-assembled on a polydopamine core, forming camouflaged nanoparticles (SPoD NPs). The SPoD NPs exhibited a commingled PDT/PTT (i.e., interdependent PTT and PDT) that inhibited both normoxic and hypoxic cancer cell growth. These nanoparticles showed stealth properties with enhanced physiological stability and passive tumor targeting. SPoD NPs also exhibited tumor suppression by synergistic PTT and PDT. It also prevented lung metastasis and splenomegaly in tumor-bearing Balb/c mice. Interestingly, treatment with SPoD NPs also caused the suppression of secondary tumors by eliciting an anti-tumor immune response. In conclusion, a co-assembled multifunctional nanosystem derived from S. oleracea showed enhanced stability and tumor-targeting efficacy, resulting in a commingled PDT/PTT effect.

The Correlation Between Cognitive Flexibility and Learning Strategies Adopted by Medical Students.

Background and objective The term cognitive flexibility refers to the ability of the students to adapt to a challenging environment. This quality has been found to enhance creativity and skills for innovation among medical students who are expected to face a taxing environment in clinical settings. Medical students should be competent enough to address the problems on their own and work with autonomy. The practice of self-regulated learning (SRL) can be associated with cognitive flexibility. Hence, this study aimed to determine the correlation between learning strategies and cognitive flexibility. Our primary objective was to correlate the different learning strategies adopted and cognitive flexibility among medical students. Material and methods This descriptive cross-sectional study was conducted at Sri Venkateshwaraa Medical College Hospital and Research Center, Ariyur, Pondicherry after obtaining institutional ethical committee approval. Students from the second year to the final year of the MBBS course who volunteered to participate in the study were selected based on inclusion and exclusion criteria. The Motivated Strategy for Learning Questionnaire (MSLQ), consisting of 50 items in Part B, was employed to assess SRL. Cognitive flexibility was measured using the Stroop Color and Word Test (SCWT) and Trail Making Test (TMT) Part A and Part B. Results The study included a total of 220 medical students. The mean age of the participants was 21.76 ± 1.77 years, and they had a healthy mean BMI of 21.06 ± 1.25 kg/m2. There was no significant difference in terms of gender in the tested variables. Responses in Card "C" and Card "CW" of the Stroop test showed a significant positive correlation (p<0.001) with subscales of SRL strategies. In the TMT, the latency of Trail A showed a significant negative correlation (p<0.001) with all the subscale scores of the SRL strategies, and the latency of Trail B showed a negative correlation with rehearsal (p=0.03), organization (p=0.03), and effort regulation strategies (p=0.01) of SRL. Conclusion Implementing SRL techniques can ultimately help medical students to act more wisely and judiciously. Hence, we propose that cognitive flexibility among medical students can be enhanced by adopting SRL strategies.

Role of high-fat diet on letrozole-induced polycystic ovarian syndrome in rats.

Polycystic ovary syndrome (PCOS) is one of the most prevalent hormonal disorders in women of reproductive age. Letrozole (LET)-induced PCOS is a good model but has drawbacks such as the absence of metabolic changes. Hence, in the present study, we aimed to develop a new animal model combining a high-fat diet (HFD) and LET. Female Wistar rats were divided into a control group, LET group, and LET + HFD (45% energy from fat) group. Compared with the control group, the LET and LET + HFD groups showed ovarian cysts and elevated testosterone levels, whereas oestradiol and progesterone levels were reduced. The LET + HFD group displayed significant changes in body weight, as well as in levels of triglycerides, fasting blood glucose, direct bilirubin, alanine aminotransferase, and uric acid; in terms of glucose intolerance and insulin resistance, the LET + HFD group showed better results than the LET group. Compared with the control group, elevated levels of tumour necrosis factor-α were detected in both the LET and LET + HFD groups. The addition of HFD to the LET model afforded good metabolic aberrations, along with ovarian cysts. In contrast, the LET-only model failed to demonstrate metabolic anomalies observed in the human PCOS condition.

Fate and reduction of bromate formed in advanced water treatment ozonation systems: A critical review.

Disinfection in water treatment and reclamation systems eliminates the potential health risks associated with waterborne pathogens, however it may produce disinfection by-products (DBPs) harmful to human health. Potentially carcinogenic bromate is a DBP formed during the ozonation of bromide-containing waters. To mitigate the problem of bromate formation, different physical/chemical or biological reduction methods of bromate have been investigated. Until now, adsorption-based physical method has proven to be more effective than chemical methods in potable water treatment. Though several studies on biological reduction methods have been carried out in a variety of bioreactor systems, such as in biologically active carbon filters and denitrifying bioreactors, the microbiological mechanisms or biochemical pathways of bromate minimization have not been clearly determined to date. Genetic analysis could provide a broader picture of microorganisms involved in bromate reduction which might show cometabolic or respiratory pathways, and affirm the synergy functions between different contributing groups. The hypothesis established from the diffusion coefficients of different electron donor and acceptors, illustrates that some microorganisms preferring bromate over oxygen contain specific enzymes which lower the activation energy required for bromate reduction. In addition, considering microbial bromate reduction as an effective treatment strategy; field scale investigations are required to observe quantitative correlations of various influencing parameters such as pH, ozone dose, additives or constituents such as ammonia, hydrogen peroxide, and/or chloramine, dissolved organic carbon levels, dissolved oxygen gradient within biofilm, and empty bed contact time on bromate removal or reduction.

In Situ Nanotransformable Hydrogel for Chemo-Photothermal Therapy of Localized Tumors and Targeted Therapy of Highly Metastatic Tumors.

Metastasis is one of the predisposing factors for cancer-related mortalities worldwide. Patients with advanced cancers (stage IV) receive palliative care with minimal possibility of achieving complete remission. Antibody-based therapeutic modalities are capable of targeting tumors that are confined to a particular location but are ineffective in targeting distant secondary tumors. In the current study, we have developed a smart nano-transforming hydrogel (NTG) that transforms in situ to polymeric nanoparticles (PA NPs) of 100-150 nm when injected subcutaneously. These nanoparticles targeted the primary and secondary metastatic tumors for up to ∼5 and ∼3 days, respectively. The in situ-formed PA NPs also demonstrated a pH-responsive drug release resulting in about ∼80% release within 100 h at 5.8 pH. When tested in vivo, substantial inhibition of lung metastases was observed compared to chemotherapy, thus demonstrating the efficiency of nanotransforming hydrogels in targeting and inhibiting primary and secondary metastatic tumors.